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Sunday, December 23rd, 2012

31. Career Update UK (03.10.2014.)

GMC to introduce new exam for all medical graduates to practise in the UK

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“All medical graduates will need to take a new exam devised by the GMC to get on to the medical register, the regulator has announced today. The ‘passport to practice’ will be taken by all trainees across the UK, including GPs, who wish to practise in the UK, including both UK graduates and overseas doctors. The GMC will begin to consider the content of the exam in June 2015 in conjunction with the Medical Schools Council, Health Education England and Education Scotland as well as doctors, patients, employers and educators among others, though there is no indication as yet to when the exam will begin. The GPC has said the plans are ‘ridiculous’ and ‘will not add anything’. It will replace the current Professional & Linguistics Assessment Board (PLAB) exam for international medical graduates, but college exams will remain. The GMC says that the exam will be designed to ‘give patients assurance about the competence and quality of those treating them, regardless of where they received their training’. Niall Dickson, chief executive of the GMC, said: ‘This is the start of a process that, if we get it right, will create a level playing field for entry into medicine in the UK. ‘There is plenty of detail to be worked out, but today we begin discussions about how to develop a single “passport to practise”.’ He added that it is unlikely that the GMC will be able to enforce this on doctors who come from the European Economic Area because of rules regarding free movement of trade. However, he added: ‘We would certainly like to see a situation where doctors from Europe themselves would wish to demonstrate that they are meeting the required standards by sitting the exam. The fact that a doctor has passed the national exam would almost certainly be noted on his or her entry on the medical register for everyone to see.’ But Dr Beth McCarron-Nash, a GPC negotiator and a GP in Cornwall, said the plans were ‘ridiculous’ and indicated that the GMC was trying to make itself ‘as unpopular as possible’. She added: ‘You are either qualified to be a doctor or you are not. To bring in yet another load of exams after graduates have passed their finals just makes it ever more difficult to become a doctor. ‘The GMC needs to look at its remit to support professionalism and doctors and I am not sure what this will add. I see some of the concerns with standardisation for international medical graduates, but until we get detail, I am not sure what this will add. I am yet to be convinced.’ Harrison Carter, co-chair of the BMA’s Medical Students Committee, said: ‘This proposal could successfully provide equal opportunities for those entering into medicine in the UK and could work to reassure patients that those treating them, regardless of where they have trained, are competent and able. ‘However we must ensure that medical students are not subjected to excessive examinations which could distract them from essential medical training.’ However, international doctors leaders welcomed the news. Dr Ramesh Mehta, president of the British Association of Physicians of Indian Origin, said: This is brilliant news. BAPIO has been asking for a single national licensing examination for UK as well as international medical graduates for a long time. This will reconfirm the competence of IMGs and challenge those who are in habit of denigrating IMGs. I hope there is no prolonged gestation period.’ It comes after the GMC earlier this year indicated that international medical graduates could face a higher bar to work in the UK after GMC-commissioned research concluded the assessment that allows them to practise medicine in this country may be too lenient. The research – published in the BMJ – found that graduates of PLAB had poorer clinical knowledge and skills than UK graduates on average, according to their performance in the MRCGP exam.”

“The number of doctors coming to work in the United Kingdom from southern Europe has risen sharply, the General Medical Council has said. The regulator’s 2014 report, The State of Medical Education and Practice in the UK, noted a shift in the pattern of doctors from overseas coming to work in the UK.[1] The GMC said that, in the past, the largest source of overseas trained doctors was southern Asia, but recently it has recorded a sharp rise in doctors from southern Europe. In 2013, more graduates from the European Economic Area (EEA) joined the medical register than other international medical graduates, the report said. A third (1840) of non-UK graduates who joined the register were from southern Europe, and a fifth were from Italy (616) or Greece (483). The GMC said, “We do not know all the reasons for these changes but some are already clear—after changes to immigration rules in 2010, it became harder for international medical graduates (IMGs) to secure training and employment here. The data suggest that the economic downturn in the EEA, and the increased opportunity for EEA graduates in the new member states to work in the UK following enlargements in 2004 and 2007, are the main reasons for the increase in the proportion of EEA graduates working here.” The GMC said that the number of doctors who joined the register from Ireland also increased considerably from five years before, from 227 in 2008 to 483 in 2013—making up 3% of those joining the register in 2013. The report also found that the number of UK graduates who were issued a certificate of good standing had increased by 22%, from 2382 in 2008, to 2899 in 2013. Certificates of good standing are usually needed when doctors working here register to work in another country. The GMC said, “Doctors who request a certificate do not always end up going abroad and, of those who do, some only leave temporarily, to further their training or experience for a short period. Nevertheless, trends in the numbers of certificates issued to overseas regulators give an indication of doctors moving out of the UK.” Most requests for certificates in 2013 were for doctors aged 25-27, who accounted for 926 (20%) of the 4741 certificates issued to overseas regulators, the report said. “Over half (51%) of doctors given a certificate in 2013 had them sent to two countries—Australia and New Zealand. A further 9.7% went to Canada, 8% went to three countries in east Asia (Hong Kong, Malaysia and Singapore), 6.7% went to Ireland, and 4.9% went to the United Arab Emirates,” the report said. It also found that more women than ever before were entering traditionally male dominated specialties such as surgery and emergency medicine. In 2013, female doctors made up 44% of licensed doctors, 49% of GPs, and 32% of specialists, the GMC said. “During 2010-13, the number of female doctors on the specialist register increased twice as fast as the number of male doctors,” the report said. “In surgery, the number of female doctors increased by 42% between 2010 and 2013, compared with 12% for male doctors, but, by 2013, 90% of surgeons were male.” It added, “Emergency medicine also saw a disparity: the number of female doctors grew by 44%, compared with 28% for male doctors, meaning female doctors accounted for a third of doctors in emergency medicine in 2013.” Commenting on the report, Niall Dickson, chief executive of the GMC, said, “The face of medicine is changing, and it is important that those responsible for workforce planning understand the implications. Of particular concern are the potential shortages in some specialist areas where there are diminishing numbers of doctors in postgraduate training and large numbers over the age of 50. Recruitment in some parts of the UK, especially deprived areas and more remote communities, is also a significant challenge.” Clare Marx, president of the Royal College of Surgeons of England, said that a 42% increase in women becoming surgeons was encouraging, but she added that, overall, only 10% of surgical consultants were women. “We are still faced with the very considerable challenge of making sure women reach the top echelons in surgery and the NHS,” she said.”